Background: According to the clinical literature, intestinal intussusception in adults is rare, is associated with a pathologic lead point, and is usually treated surgically. Nonobstructing small bowel intussusception...Background: According to the clinical literature, intestinal intussusception in adults is rare, is associated with a pathologic lead point, and is usually treated surgically. Nonobstructing small bowel intussusception has been reported as a transient finding on computed tomographic (CT) studies. Methods: We evaluated the radiographic and clinical findings in 24 patients who were found to have 26 proximal small bowel intussusceptions on abdominal CT scans performed for a variety of indications. Results: Twenty patients with intussusceptions had no evide nce of small bowel obstruction. The transient and clinically insignificant nature of 22 intussusceptions in these 20 patients was proven radiologically (n=14), surgically (n=1), or by clinical follow up (n=7). These patients demonstrated a bowel within bowel pattern on multiple contiguous images and absence of stran gulation or intestinal dilatation. No lead points were demonstrated in these pat ients. Three other patients had symptoms of low grade small bowel obstruction a nd were treated conservatively. Extensive follow up investigations showed no re currence of intussusception or a lead point. One patient had high grade obstruc tive intussusception with intestinal ischemia and required surgical resection of necrotic bowel. Conclusions: Proximal small bowel intussusceptions are likely t o be transient and nonobstructive and unlikely to have a significant lead point.展开更多
文摘Background: According to the clinical literature, intestinal intussusception in adults is rare, is associated with a pathologic lead point, and is usually treated surgically. Nonobstructing small bowel intussusception has been reported as a transient finding on computed tomographic (CT) studies. Methods: We evaluated the radiographic and clinical findings in 24 patients who were found to have 26 proximal small bowel intussusceptions on abdominal CT scans performed for a variety of indications. Results: Twenty patients with intussusceptions had no evide nce of small bowel obstruction. The transient and clinically insignificant nature of 22 intussusceptions in these 20 patients was proven radiologically (n=14), surgically (n=1), or by clinical follow up (n=7). These patients demonstrated a bowel within bowel pattern on multiple contiguous images and absence of stran gulation or intestinal dilatation. No lead points were demonstrated in these pat ients. Three other patients had symptoms of low grade small bowel obstruction a nd were treated conservatively. Extensive follow up investigations showed no re currence of intussusception or a lead point. One patient had high grade obstruc tive intussusception with intestinal ischemia and required surgical resection of necrotic bowel. Conclusions: Proximal small bowel intussusceptions are likely t o be transient and nonobstructive and unlikely to have a significant lead point.
